The American College of Radiology (ACR) was founded in 1963 to promote continuous quality improvement for imaging facilities, and the ultrasound accreditation program began in 1995. It has many different standards that facilities must meet and maintain for accreditation. The standards apply to the sonographers performing the exams, the physicians reading the exams, the physical environment the exams are performed in, policies and procedures, and—last but not least—the quality control program for the equipment, which will be the focus of this article. While accreditation is voluntary, imaging facilities with ACR (or similar) accreditation, have a distinct advantage over non-accredited facilities. The first is prestige: A facility can distinguish itself from others by having that seal of approval. The second advantage is financial: Some state agencies and private insurance companies tie reimbursements to facilities with accreditation by ACR or a comparable national group. Where do we as maintenance providers fit into this equation? The quality control standards of the ultrasound systems set by ACR are specific and must be maintained on every ultrasound system within the accredited department at specific intervals to receive and maintain accreditation. I wrote “within the accredited department” because within a given facility, there are ultrasound systems in many departments—radiology, cardiology, emergency, obstetrics, labor and delivery, oncology, urology, and vascular—but not all departments are accredited. Each organization should determine which specific departments are to be ACR certified. The latest ACR ultrasound accreditation program requirements can be found at: http://www.acr.org/accreditation/ultrasound/ultrasound_reqs.aspx These performance and safety standards cover imaging grey scale/hard copy, electrical matters, cleanliness, system/ probe penetration and sensitivity, vertical and horizontal measurement accuracy (recommended but not required), image uniformity, and low-contrast object detectability. The standards also address safety and mechanical inspections of the system and transducers. These tests should be performed using the same type of probes (preferably the most common two) and imaging parameters (depth, output power, transmit zone location, etc.) with each inspection to maintain the integrity of test results and to see changes in system performance over time. Both test results and corrective actions must be documented. For example, if, during a preventive maintenance (PM) check, you find signal dropouts with a transducer, that needs to be documented. When that transducer is repaired or replaced, that action also needs to be documented. All maintenance and repair documents must be kept on site for inspection. Are you documenting all quality assurance and maintenance visits for all of your accredited equipment? If you use the original equipment manufacturer (OEM) or other service provider, do they provide you with these reports? Does the process they follow meet ACR standards? ACR also recommends—but does not require—the use of a tissue-mimicking phantom, but performing some ACR Ultrasound Accreditation: How Does That Impact Equipment Maintenance?